Individual provider Active NPI

Linda Maxwell

  • Speech-Language Pathologist
  • Reston, VA
National Provider Identifier
1376768457
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202002788 Issued in VA
Practice address
1850 Cameron Glen Dr
Suite 100
Reston, VA 20190-3363
Phone
(703) 481-4237
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202002788 VA Primary

Addresses

Primary practice location

1850 Cameron Glen Dr
Suite 100
Reston, VA 20190-3363

Mailing address

10420 Rifle Rd
Bristow, VA 20136-1329
Phone (703) 869-3748

Other names 1

  • Linda Cometto Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2202002788VAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376768457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 RIFLE RD",
            "city": "BRISTOW",
            "state": "VA",
            "postal_code": "201361329",
            "telephone_number": "703-869-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 CAMERON GLEN DR",
            "address_2": "SUITE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903363",
            "telephone_number": "703-481-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "LINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202002788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "COMETTO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.